Healthcare Provider Details

I. General information

NPI: 1740596444
Provider Name (Legal Business Name): GENESYS AMBULATORY HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2010
Last Update Date: 03/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 N CENTER RD
BURTON MI
48509-1429
US

IV. Provider business mailing address

1460 N CENTER RD
BURTON MI
48509-1429
US

V. Phone/Fax

Practice location:
  • Phone: 810-715-1460
  • Fax: 810-715-4602
Mailing address:
  • Phone: 810-715-1460
  • Fax: 810-715-4602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateMI

VIII. Authorized Official

Name: MS. DONNA L. NAPIER
Title or Position: MANAGER
Credential: CMA, COHC
Phone: 810-715-1460